tbuckley/cabot-search huggingface dataset:
Risk of skeletal-related events (SREs) in patients with breast cancer (BC) and newly diagnosed metastases to bone.
Authors: Charu Taneja, Lois Lamerato, Andrew Glass, Kathryn E. Richert-Boe, John Edelsberg, Greg G. Wolff, Natalie Czapski, Karen Chung, Akshara Richhariya, Gerry Oster
Journal: Journal of Clinical Oncology (2012)

91 Background: Bone is a common site of metastatic involvement in patients (pts) with BC. Bony metastases (mets) are often associated with SREs (spinal cord compression [SCC], pathologic fracture [PF], surgery to bone [SB], radiotherapy to bone [RT]). Skeletal complications cause significant morbidity and mortality. Current estimates of SRE risk come principally from randomized clinical trials. Information from routine clinical practice is limited. Methods: Using the tumor registry and electronic data stores at a large U.S. Midwest healthcare system that serves approximately 800,000 persons, we retrospectively identified all pts aged ≥18 yrs with primary BC and newly diagnosed bone mets between 1/1/95 and 12/31/09. Electronic medical records were reviewed by trained abstractors for evidence of SREs between date of bone mets diagnosis and death, loss to follow-up, or end of study. Cumulative incidence of SREs was estimated in the presence of competing risk of death. Results: We identified a total of 378 pts with primary BC and newly diagnosed bone mets; 87 pts had evidence of SREs at initial diagnosis of bone mets and were excluded from the analyses. Among the remaining 291 pts, mean (SD) age was 58.2 yrs (14.3 yrs), and 99% were women; 48% were African-American and 46% were Caucasian. Median duration of follow-up after diagnosis of bone mets was 16.1 months (mos). At 12 mos, cumulative incidence of SREs was 44.5% (SCC, 5.2%; PF, 21.0%; SCC and/or PF, 23.3%; SB, 7.6%; RT, 34.3%) (Table). Corresponding figures at 24 mos were 53.8% (SCC, 7.5%; PF, 29.3%; SCC and/or PF, 32.5%; SB, 9.4%; RT, 41.7%). Approximately one-half (45.0%) of study subjects received intravenous bisphosphonates prior to SRE. Conclusions: Pts with BC in routine clinical practice are at high risk of SREs following initial diagnosis of bone mets. [Table: see text]
Formationes Vascular del Labios con Reguardo al Ulcere Peptic
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract PR05: Mapping the tumor and microenvironmental evolution underlying DCIS progression through multiplexed ion beam imaging
Authors: Tyler Risom, Belen Rivero, Candace Liu, Alex Baranski, Siri Strand, Noah Greenwald, Erin McCaffrey, Sushama Varma, Leeat Keren, Sucheta Srivastava, Chunfang Zhu, Sujay Vennam, Shelley Hwang, Graham Colditz, Sean Bendall, Robert West, Michael Angelo
Journal: Cancer Research (2020)

Abstract Ductal Carcinoma in Situ (DCIS) is a pre-invasive lesion that accounts for nearly 20% of new breast cancer diagnoses. Of these cases, about half will progress to invasive breast cancer (IBC) within ten years. However, because diagnostic criteria for delineating low risk lesions from those likely to progress to IBC have not been identified, many patients are receiving unnecessary chemotherapy and surgery that can result in therapy-related morbidity and death. With this in mind, we used Multiplexed Ion Beam Imaging by time of flight (MIBI-TOF) and RNA-seq laser-capture microdissection (SMART-3SEQ) to construct a comprehensive spatial atlas describing the structure, function, and cellular composition of DCIS. MIBI-TOF and SMART-3SEQ were used to compare lesions from patients that later developed IBC with those from age- and history matched DCIS controls without recurrence. Using a 37-marker staining panel to interrogate 137 lesions, we identified 30 distinct cell populations of the epithelial, stromal, and immune lineages that were arranged in recurrent cellular microenvironments specific for DCIS or invasive disease. We observe a coordinated shift in the immune and stromal compartments as invasive disease arises, including an expansion of immune cell diversity and transition to reactive stromal phenotypes in synchronous DCIS + IBC, which was distinct from the macrophage-dominant microenvironment of recurrent IBC. Single-cell segmentation using a deep learning model was combined with pixel-level coexpression analysis to determine how thickness, continuity, and phenotype of ductal myoepithelium changes as tumors progress from a pre-invasive state. These data were incorporated into a comprehensive model which was subsequently used to identify a subset of features that correlate with disease-free survival following DCIS tumor resection. Taken together, these features represent important prognostic metrics that can be used to separate pre-invasive from indolent DCIS tumors, and allow for tailored therapy that improves patient outcomes and quality of life in this disease. Citation Format: Tyler Risom, Belen Rivero, Candace Liu, Alex Baranski, Siri Strand, Noah Greenwald, Erin McCaffrey, Sushama Varma, Leeat Keren, Sucheta Srivastava, Chunfang Zhu, Sujay Vennam, Shelley Hwang, Graham Colditz, Sean Bendall, Robert West, Michael Angelo. Mapping the tumor and microenvironmental evolution underlying DCIS progression through multiplexed ion beam imaging [abstract]. In: Proceedings of the AACR Virtual Special Conference on Tumor Heterogeneity: From Single Cells to Clinical Impact; 2020 Sep 17-18. Philadelphia (PA): AACR; Cancer Res 2020;80(21 Suppl):Abstract nr PR05.
Risk Characterization Framework for Noncancer End Points
Authors: Terrence K. Pierson, Robert G. Hetes, Dennis F. Naugle
Journal: Environmental Health Perspectives (1991)

The nature of both indoor air exposures and noncancer end points present significant issues for risk characterization. Noncancer end points are multidimensional, affecting various organs, and are assumed to have thresholds. Symptoms also vary in severity within a population. In addition to the complexity of noncancer risk assessment, indoor air exposures are typified by the presence of complex mixtures, which further complicates the complex nature of noncancer risk characterization. Most noncancer risk assessment efforts have focused on defining acceptable daily intakes or reference doses (RfD) rather than estimating incidence and severity of the wide range of effects within an exposed population. The risk characterization framework has been developed to accommodate the RfD approach but, more importantly, to address the multidimensional nature of noncancer risk characterization. Newly emerging methods and standard EPA risk assessment guidelines for noncancer effects and complex mixtures were used as guides for developing the framework. Information and data needs have been identified from the framework. Peak, average, and cumulative doses from indoor air exposures are highly dependent on variable indoor air concentrations and affected by time-activity patterns. Susceptibility also plays a significant role in noncancer end points and, unlike susceptibility in cancer risk assessment, is quantifiable. This paper highlights the risk characterization framework for noncancer health risks that we developed in cooperation with the U.S. Environmental Protection Agency Environmental Criteria and Assessment Office. Additionally, a preliminary application of the framework to a complex mixture of volatile organic compounds from indoor sources is illustrated.
Abstract 4246: Association of transcriptional levels of folate-mediated one-carbon metabolism related genes in cancer cell lines with drug treatment response
Authors: Julia Krushkal, Suleyman Vural, Dong-Joon Min
Journal: Cancer Research (2019)

Abstract Folate-mediated one-carbon metabolism (OCM) is essential for growth and survival of cancer cells. It affects biosynthesis of nucleotides and amino acids, regulation of redox status, methylation of nucleic acids and proteins, and genome maintenance. We investigated whether the response of cancer cells to antitumor therapy treatment may be partially influenced by variation in expression of one-carbon metabolism genes. We used publicly available gene expression data and drug response measures for 251 antitumor agents in 635 cancer cell lines with matching information from the Cancer Cell Line Encyclopedia and the Genomics of Drug Sensitivity in Cancer resources. We examined whether pre-treatment expression levels of OCM-related genes were associated with drug response. Among the 34 OCM genes examined, expression of GART, TYMS, SHMT2, MTR, ALDH2, BHMT, MAT2B, MTHFD2, NNMT, and SLC46A1 showed modest correlations with response to treatment with a variety of antitumor agents. Higher expression levels of the SLC46A1 transporter gene were associated with resistance to multiple drugs, whereas elevated expression of GART, TYMS, SHMT2, MTR, BHMT, and MAT2B was associated with chemosensitivity to multiple antitumor agents. NNMT expression was bimodally distributed and showed different directions of association with various agents. Correlation of increased NNMT expression with sensitivity to dasatinib was validated in the NCI-60 cancer cell line panel. Expression of several OCM genes was strongly associated with expression of multiple components of drug target pathways. For example, expression of both TYMS and GART was strongly positively correlated with BRCA1 expression, NNMT expression was associated with expression of multiple drug target genes including EGFR and ABL2, and the expression of TYMS, DHFR, and SHMT1 was positively correlated with AURKB expression. Pretreatment expression levels of many OCM genes including DHFR, TYMS, ATIC, GART, AHCY, MTHFD1, SLC19A1, and multiple other genes were positively correlated with each other, suggesting their co-regulation. In contrast, NNMT expression was negatively correlated with expression of several other OCM genes. Further studies could investigate whether correlations of expression levels of individual OCM genes with drug response are related to specific metabolic roles of these genes or whether such associations may be due to the general increase in cellular growth and proliferation and tumor progression, which may affect sensitivity to cancer treatment. Citation Format: Julia Krushkal, Suleyman Vural, Dong-Joon Min. Association of transcriptional levels of folate-mediated one-carbon metabolism related genes in cancer cell lines with drug treatment response [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4246.
Veiled Purpose
Authors: Alfred P. Ingegno
Journal: Annals of Internal Medicine (1992)

Ad Libitum1 July 1992Veiled PurposeAlfred P. Ingegno, MDAlfred P. Ingegno, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-1-88 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThese many years the vision and the words keep creeping back to slyly haunt and mock in me the Healing Art so poorly used, a beamless beacon with no light to rouse to view John's darkly shadowed mind, and sense its nest of hopeless phantoms urging death.I thought it hard to say to him straight out "there's cancer there," and leave no shred of hope, but chose instead to pantomime the truth with mealy words to soften what they meant. But while I strove to shield him from the hurt, he cooly saw the truth and laid his plan.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Brooklyn, NY 11217 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1992Volume 117, Issue 1Page: 88-88KeywordsVision ePublished: 1 December 2008 Issue Published: 1 July 1992 PDF downloadLoading ...
The importance of placebo effects in pain treatment and research
Authors: J. A. Turner
Journal: JAMA (1994)

<h3>Objective.</h3> —To estimate the importance and implications of placebo effects in pain treatment and research from the existing literature, with emphasis on their magnitude and duration, the conditions influencing them, and proposed explanations. <h3>Data Sources.</h3> —English-language articles and books identified through MEDLINE (1980 through 1993) and PsycLIT (1967 through 1993) database searching, bibliography review, and expert consultation. <h3>Study Selection.</h3> —Articles were included if they pertained to the review objectives. <h3>Results.</h3> —Placebo response rates vary greatly and are frequently much higher than the often-cited one third. Placebos have time-effect curves, and peak, cumulative, and carryover effects similar to those of active medications. As with medication, surgery can produce substantial placebo effects, and this possibility is commonly overlooked in case series reports on back surgery. Individuals are not consistent in their placebo responses, and a placebo-responder personality has not been identified. Models advanced to explain placebo effects emphasize the role of anxiety, expectations, and learning. <h3>Conclusions.</h3> —Placebo effects influence patient outcomes after any treatment, including surgery, that the clinician and patient believe is effective. Placebo effects plus disease natural history and regression to the mean can result in high rates of good outcomes, which may be misattributed to specific treatment effects. The true causes of improvements in pain after treatment remain unknown in the absence of independently evaluated randomized controlled trials. (<i>JAMA</i>. 1994;271:1609-1614)
The appropriateness of performing coronary angiography and coronary artery revascularization in a Swedish population
Authors: A. Bengtson
Journal: JAMA (1994)

<h3>Objective.</h3> —To evaluate the appropriateness of performing coronary angiography and revascularization in a Swedish population. <h3>Design.</h3> —Prospective population study of questionnaires and medical records. <h3>Setting.</h3> —All the hospitals in southwestern Sweden that perform coronary angiography and revascularization. <h3>Patients.</h3> —Random sample of 831 patients (with chronic stable angina) on the waiting list for coronary angiography or revascularization in southwestern Sweden in September 1990. <h3>Main Outcome Measure.</h3> —Percentage of patients referred for coronary angiography or revascularization for appropriate, uncertain, or inappropriate indications. <h3>Results.</h3> —Of the patients referred for angiography, 89% were classified as appropriate, 9% as uncertain, and 2% as inappropriate. The percentages are similar for patients referred for coronary artery bypass graft surgery and for angioplasty (91% and 86%, respectively, classified as appropriate). The majority of patients had chest pain rated as Canadian Cardiovascular Society classes II through IV (93%), despite maximum anti-ischemic therapy in 90% of these patients. <h3>Conclusions.</h3> —Few patients were referred for coronary angiography or revascularization for inappropriate or uncertain indications. The percentage of these patients who are from southwestern Sweden is similar to the percentage recently reported from New York State. (<i>JAMA</i>. 1994;271:1260-1265)
<i>QuickStats:</i> Age-Adjusted Percentage* of Adults Aged ≥18 Years Who Were Never in Pain, in Pain Some Days, or in Pain Most Days or Every Day in the Past 6 Months,<sup>†</sup> by Employment Status<sup>§</sup> — National Health Interview Survey,<sup>¶</sup> United States, 2016
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

Department of Health and Human Services/Centers for Disease Control and Prevention * With 95% confidence intervals indicated by error bars.Percentages were age-adjusted to the projected 2000U.S. population as the standard population, using five age groups: 18-29, 30-39, 40-49, 50-59, and ≥60 years.† Based on responses to the question "In the past 6 months, how often did you have pain?Would you say never, some days, most days, or every day?"For this figure, response categories "most days" and "every day" are combined.§ Based on responses to the following questions: "What was [person]/were you doing last week?"and "Have you ever held a job or worked at a business?"Based on the first question, adults who were "working for pay at a job or business, " "with a job or business but not at work, " or "working, but not for pay, at a family-owned job or business" were classified as "currently employed." Adults who were "looking for work" or "not working at a job or business and not looking for work" based on the first question and who subsequently answered "yes" to the second question were classified as "previously employed." Adults who were "looking for work" or "not working at a job or business and not looking for work" based on the first question and who subsequently answered "no" to the second question were classified as "never employed." ¶ Estimates are based on household interviews of a sample of the civilian, noninstitutionalized U.S. population
9. Pharmacologic Approaches to Glycemic Treatment: <i>Standards of Medical Care in Diabetes—2021</i>
Journal: Diabetes Care (2020)

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc21-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc21-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Elevated carcinoembryonic antigen levels and biliary tract obstruction
Authors: B. B. Lurie
Journal: JAMA (1975)

Circulating carcinoembryonic antigen (CEA) levels and their relation to liver function test values were studied in 29 jaundiced patients with benign extrahepatic biliary tract obstruction and inflammation. During the obstructive and inflammatory phase, 15 (52%) of the patients had CEA levels greater than 2.5 ng/ml. Elevated CEA levels were associated more frequently with common bile duct stones (and cholangitis) than with gallbladder stones (and cholecystitis) alone, although this difference was not statistically significant. The former often had values greater than 5.0 ng/ml. The highest values were found in two patients with liver abscesses. The CEA levels returned to normal following relief of obstruction in seven of ten patients and increased in two patients who had progressive inflammation. Serum alkaline phosphatase and bilirubin levels were significantly higher in the patients with elevated CEA levels (P &lt;.05). Serum alkaline phosphatase levels showed a significant positive correlation with CEA levels (P &lt;.02). Patients with obstructive jaundice and elevated CEA levels do not necessarily have cancer. (<i>JAMA</i>233:326-330, 1975)
THE ENTERTAINMENTS.
Journal: JAMA (1889)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
An agenda for research in medical education
Authors: P. J. Sanazaro
Journal: JAMA (1966)

The 1960's stand recorded as the decade in which national goals for American society became inseparable from national goals for medicine and medical education. Federal legislation has established equal access of all citizens to the full benefits of modern health care as a basic social right. Equal access is to be promoted by removal of economic and social barriers, by innovations in the delivery of health services, and by increasing the numbers of health care personnel. What was before a philosophical view has become a guiding principle: medical education must be consciously directed to meeting the medical care needs and demands of society on the local, regional, and national levels. Far reaching decisions will be made, and quickly, because the combination of money and mandate is uniquely persuasive. However, medical schools cannot fully adapt in one spasm of pragmatic decisions. Their capacity to respond is limited in part by the